Exercise Is a Necessary Treatment for All Types of Arthritis

by Dr. Gabe Mirkin, M.D.

Arthritis is classified into three types:

1. Inflammatory
2. Degenerative
3. Traumatic

Your doctor first checks to see if you have a history of trauma that damaged your joint. If you don't, he does a host of blood tests looking for a source of inflammation (an overactive immunity): various diseases, infections or the deposition of crystals in the joint fluid. If he finds none of these, he announces to you that you have osteoarthritis, which means that he doesn't have the foggiest idea what is causing your joint pain. He then does X-rays and MRIs. If the cartilage is gone and a bone at the joint touches the end of the opposing bone, he may recommend a joint replacement. If the cartilage is intact, the major treatment is exercise (Current Pain and Headache Reports, December 2011: 15(6):423-30).

Regardless of the cause of your joint pain, inactivity will increase damage to the joint. If you don't move that joint, you can expect it to degenerate to the point where the joint loses its ability to move through its full range of motion. When you stop using a joint, the muscles around it grow weak and the tendons stiffen. This leads to further joint damage and lack of mobility. Of course, you should not pound on, or apply too much force on damaged joints because too much force can break more cartilage, leading to a joint replacement.

DO NOT RUN WITH ARTHRITIS IN KNEES OR HIPS

Running is almost always contraindicated if you have joint damage in the legs, hips or lower back because during running, your foot hits the ground with a force that is transmitted up your leg all the way to your back. The faster you run, the greater and more damaging the force of your foot strike. If you want to run with joint pain, you must run very slowly, and even then, you are still transmitting the foot strike force up your leg and into your back.

BEST SPORTS FOR ARTHRITIS

The safest sports for people with painful joints are those that do not involve foot strike force. Cycling is done in a smooth rotary motion. Swimming helps protect your joints because of the buoyancy of the water. Exercise equipment such as elliptical trainers or stair steppers will allow you to move your joints without pounding on your feet. Any of these activities help you to strengthen the muscles around the damaged joints and keep the tendons flexible. Whatever sport you choose, the same rules of training that athletes use apply to you:

BACKGROUND BEFORE PEAKING

Start out by pedaling, walking or swimming very slowly and stop if your muscles feel heavy or hurt. Stop even if you have just started your workout for that day. When you can pedal, walk or swim for 30 minutes a day without increasing your joint pain, you are ready to start training.

STRESS AND RECOVER

If you do not exercise intensely enough to feel some burning in your muscles, your muscles will not get stronger. You have to work hard enough to damage muscles because healing strengthens them. Athletes take a harder workout on one day in which they feel a burning in their muscles. When you exercise hard enough to feel sore on the next day, you should go slowly for as many days as it takes for the muscles to heal and the soreness to go away. The normal soreness you feel 8 to 24 hours after you have taken an intense workout is called Delayed Onset Muscle Soreness (DOMS).

THE DIFFERENCE BETWEEN DOMS AND AN INJURY

DOMS is symmetrical; you feel the same soreness on both sides of your body. Also, DOMS does not worsen with easy exercise. Stop exercising immediately if the pain does not improve as you continue to move. If your discomfort increases as you exercise, you have an injury or are headed for an injury.

IF YOUR JOINTS HURT TOO MUCH TO EXERCISE

If your joint pain is so severe that you cannot exercise, you need to find some way to have your joints moved for you. Go to a physical therapist who will move your joints for you and use massage, heat, cold or electrical stimulation to help you regain the ability to move the joints. Allowing your joints to stay in one position without daily movement will cause further joint damage and make your arthritis pain worse.